This study will develop and evaluate a case management system to improve the delivery and accessibility of existing drug abuse treatment programs in Iowa. The case management model addresses the problems faced by rural clients and treating professionals with three innovative components: 1. Use of a previously tested and successful model of case management developed by Dr.James Hall, the Principal Investigator of this project, which was devised to help retain drug abusing adolescents in treatment as part of Project PALS (Positive Adolescent Life Skills), a NIDA-funded research project in San Diego. This model will be adapted to the populations served by the Iowa treatment programs. 2. Use of a computerized telecommunications component as a way to improve communication and help overcome obstacles to services. This program has been developed by Dr. Farrokh Alemi under NIDA auspices. This component will allow clients, through an "800" telephone number to access a computerized system which will provide (a) information, (b) counseling via telephone with the case manager or with a group of other clients with similar concerns, and (c) reminders of meetings or other components of treatment. 3. Two "locations" of case managers will be tested to determine the impact on services of: (a) affiliation and location of the manager within the treating agency (internal site) versus (b) affiliation and location of the manager in an outside independent agency (external site). This component of the experimental design will help to answer the question posed by state officials in Iowa who are interested in case management services as an enhancement to alcohol and drug treatment. The study will evaluate the efficacy of case management in publicly- funded drug treatment programs in two predominantly rural catchment areas in Iowa. Eight counties are served by these two catchment areas, which are fairly representative of Iowa counties. One county is a Standard Metropolitan Statistical Reporting area, one county is semi-rural, and six are defined as rural. Catchment areas were also selected with racial/ethnic representation in mind. A factorial experimental design will be used. Clients will be randomly assigned to the experimental factors of (1) case manager employed by the drug treatment agency; (2) case manager employed by an organization independent of the drug treatment agency; (3) computerized case management; and (4) standard drug treatment. Treatment outcome and treatment process will be monitored in order to assess the efficacy and cost effectiveness of case management in rural drug treatment. Clients will be followed at least 12 months. Efficacy of case management will be measured by comparing client groups on variables such as: (1) treatment drop-out rates, (2) treatment compliance, (3) recidivism to drug use/abuse and/or to criminal behavior, (4) social functioning, (5) cost-effectiveness, etc. Multivariate statistics will be used to control for variables affecting outcome such as comorbid psychiatric conditions.